Ozeki Y, Matsumoto K, Goto M, Hayashi M, Onitsuka A, Hirose M, Shimokawa K
First Department of Surgery, Gifu University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1988 Mar;89(3):458-63.
A case of renal angiomyolipoma with bone formation is reported. A 61-year-old woman was admitted to our hospital with one month history of fever. About 15 cm in diameter mass was palpated in her right lower abdomen. Plain abdominal roentgenography, ultrasonography and computed tomography showed marked calcification in the cephalic portion of the right kidney, tumors surrounding right kidney and another tumor in the right lower abdomen. All these tumors and the kidney constituted a big mass continuously, and no fatty component was demonstrated. Total excision of the mass including the kidney was performed. The mass was 30 X 24 X 10 cm in size and 3,240 g in weight. Histologically, the tumor was compatible to renal angiomyolipoma. But, radiopaque shadows which looked like calcification were disclosed to be bones, and fatty tissues were not seen so much. Therefore, the name "benign mesenchymoma" was thought to be more acceptable than angiomyolipoma in this case. Preoperative diagnosis of renal angiomyolipoma is the demonstration of fatty densities in the tumor, and the characteristic extrarenal development should also be taken into consideration. Furthermore, the bone formation of angiomyolipoma, which is very rare might be an important finding to angiomyolipoma.
报告一例伴有骨形成的肾血管平滑肌脂肪瘤。一名61岁女性因发热1个月入住我院。在其右下腹部可触及一个直径约15厘米的肿块。腹部平片、超声及计算机断层扫描显示右肾头部有明显钙化，右肾周围有肿瘤，右下腹部还有一个肿瘤。所有这些肿瘤与右肾连续构成一个大肿块，未显示脂肪成分。对包括右肾在内的肿块进行了完整切除。肿块大小为30×24×10厘米，重量为3240克。组织学检查显示，该肿瘤符合肾血管平滑肌脂肪瘤。但是，看起来像钙化的不透X线阴影经证实为骨骼，且未见大量脂肪组织。因此，在本例中，“良性间叶瘤”这一名称比血管平滑肌脂肪瘤更合适。肾血管平滑肌脂肪瘤的术前诊断是肿瘤内显示脂肪密度，同时也应考虑其特征性的肾外生长情况。此外，血管平滑肌脂肪瘤的骨形成非常罕见，这可能是血管平滑肌脂肪瘤的一个重要表现。
